Active NPI
Jenny Machelle Elyea, BOCPD
- Pedorthist
- Sioux Falls, SD
National Provider Identifier
1275906364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pedorthist
- License
- C52253
- Practice address
- 2105B S Minnesota Ave
Sioux Falls, SD 57105-3709 - Phone
- (605) 274-0138
- Fax
- (605) 274-0139
- NPI assigned
- Nov 11, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pedorthist | 224L00000X | C52253 | SD | Primary |
Addresses
Primary practice location
2105B S Minnesota Ave
Sioux Falls, SD 57105-3709
Mailing address
2105B S Minnesota Ave
Sioux Falls, SD 57105-3709
Phone (605) 274-0138
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C52253 | SD | MD | Pedorthist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447200000000",
"number": "1275906364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2105B S MINNESOTA AVE",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571053709",
"telephone_number": "605-274-0138",
"fax_number": "605-274-0139"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2105B S MINNESOTA AVE",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571053709",
"telephone_number": "605-274-0138",
"fax_number": "605-274-0139"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELYEA",
"first_name": "JENNY",
"middle_name": "MACHELLE",
"credential": "BOCPD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-11",
"last_updated": "2015-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "224L00000X",
"taxonomy_group": "",
"desc": "Pedorthist",
"state": "SD",
"license": "C52253",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sioux Falls, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.